Suzanne M. Thoyre is a Frances Hill Fox Term Distinguished Professor, School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, NC. She can be reached by email at
MCN Am J Matern Child Nurs. 2016 Jul/Aug;41(4):204-211. doi: 10.1097/NMC.0000000000000245.
The purpose of this study is to describe implementation of the Co-Regulated Feeding Intervention (CoReg), when provided by mothers and guided by intervention nurses trained in methods of guided participation (GP). Co-regulated feeding intervention aims to prevent stress during feeding and ease the challenge very preterm (VP) infants experience coordinating breathing and swallowing during the early months. Guided participation is a participatory learning method to guide the complex learning required for mothers.
Sixteen mothers of 17 VP infants participated. Each mother received a median of five intervention sessions during the infant's transition to oral feeding. Intervention field notes, audio recordings of the sessions, and video recordings of the nurse-guided feedings were reviewed, organized, and content analyzed to evaluate implementation.
The co-regulated feeding intervention was well received by mothers; enrollment, participation, and retention rates were high. Most mothers chose to spread out the intervention sessions across the transition period. Scheduling sessions was the greatest barrier. Mothers had competing demands and infant readiness to eat could not be predicted. The top five issues identified as needing attention by the mother or nurse included reading cues, coregulating breathing, providing motoric stability, regulating milk flow, and providing rest periods. Main GP strategies included joint attention with the mother to the dyad's feeding challenges, auditory assessment of breathing and swallowing, and reflection with planning for future feedings using video playback.
Nurse presence while mothers feed affords rich opportunities to guide coregulated, cue-based feeding. Co-regulated feeding intervention would be enhanced if mothers are guided by the bedside nurse.
本研究旨在描述 Co-Regulated Feeding Intervention（CoReg）的实施情况，该干预由接受过指导参与方法（GP）培训的护士指导母亲进行。Co-Regulated Feeding Intervention 旨在预防喂养过程中的压力，并缓解非常早产儿（VP）在生命早期协调呼吸和吞咽时遇到的挑战。指导参与是一种参与式学习方法，用于指导母亲所需的复杂学习。
17 名 VP 婴儿的 16 位母亲参与了研究。每位母亲在婴儿过渡到口服喂养期间接受了中位数为五次的干预课程。干预现场笔记、会议的音频记录和护士指导喂养的视频记录进行了回顾、组织和内容分析，以评估实施情况。
Co-Regulated Feeding Intervention 受到母亲的欢迎；参与率、参与率和保留率均很高。大多数母亲选择在过渡期间分散干预课程。安排课程是最大的障碍。母亲有竞争的需求，并且无法预测婴儿的进食准备情况。母亲或护士确定的前五个需要注意的问题包括解读提示、共同调节呼吸、提供运动稳定性、调节奶流和提供休息时间。主要的 GP 策略包括与母亲共同关注母婴喂养挑战、对呼吸和吞咽进行听觉评估，以及使用视频回放为未来的喂养提供反思和计划。
母亲喂食时护士的存在提供了丰富的机会来指导共同调节、基于提示的喂养。如果母亲能够得到床边护士的指导，Co-Regulated Feeding Intervention 将得到加强。
